Why Do I Keep Getting Strep Throat? Causes & Treatments

Strep throat is a common, but often very painful, bacterial infection. Although it most often affects kids aged five to 15, anyone can contract a strep infection.¹ Unfortunately, some people struggle with recurrent strep throat, meaning the infection returns multiple times within a single year. 

If your strep throat comes back after finishing antibiotics, keep reading to learn about why you keep getting strep throat, its possible causes, and available treatment options for your recurrent infection.

What Is Strep Throat?

Strep throat is a bacterial infection that affects the throat and tonsils. It’s caused by a type of bacteria known as group A Streptococcus, hence the name “strep throat”. Strep throat accounts for 5% to 15% of new sore throat cases in the U.S. and 15% to 35% of new sore throat cases in children.²

The earliest symptom of strep throat is a sudden sore throat. This may be accompanied by the rapid onset of a fever, as well as:

• Headache
• Chills
• Nausea
• Vomiting
• Loss of appetite
• Pain in the abdomen

It can be challenging to differentiate strep throat from other infections, like the common cold and flu, based on symptoms alone. However, while many strep symptoms overlap with colds and the flu, strep usually doesn’t trigger coughing or a runny nose.³

You may also be able to identify strep throat by looking at your throat and tonsils in the mirror. They may appear red and inflamed, with pus or white patches on the tonsils. 

The only way to know for sure that you have strep throat, not a viral infection, is to get tested by a healthcare provider. Rapid strep tests, which involve simply swabbing the throat, can provide results in as soon as 30 minutes.

Can You Get Strep Throat Twice?

After experiencing the discomfort of strep throat once, many people wonder: Can you get strep back to back, and can you get strep twice in a month? Unfortunately, the answer is yes, you can get strep repeatedly, even twice in a single month. This is known as recurrent strep, and it can be extremely frustrating—not to mention disruptive to your day-to-day routine. 

Since strep throat is a bacterial infection, it requires antibiotic medication to clear the bacteria. This is different from common viral infections, like the common cold, which your immune system can effectively fight on its own. In most cases, your immune system alone can’t fully eradicate the strep-causing bacteria. 

How does this relate to getting strep throat repeatedly, you might ask? Well, it means that strep bacteria can be very stubborn, and certain cases require a second course of antibiotics to completely clear the infection.⁴

My Strep Throat Came Back After Finishing Antibiotics

If strep throat comes back after you finish a course of antibiotics (taken as directed by your physician), you are likely reinfected with new strep bacteria. Unfortunately, strep bacteria is very contagious and can linger, especially in schools, making reinfection very possible even after a complete course of antibiotics.

Who Gets Recurring Strep Throat?

Recurring or chronic strep throat can happen to anyone who’s exposed to strep bacteria. However, it’s more likely to affect:³

• Children and adults in close contact with children, like parents and teachers
• People who have a weakened immune system
• People who are allergic to penicillin, as other antibiotics may be less effective at clearing strep infections⁴
• People who are strep carriers, meaning they carry strep bacteria on their tonsils all the time, but don’t typically experience strep throat symptoms. If strep carriers experience sore throat symptoms and get tested for strep, they’ll always test positive. This may make it seem like they’re experiencing recurrent strep infections.

What Causes Recurring Strep Throat in Adults?

Wondering why you get strep throat so often? Recurring strep throat in adults can be caused by reinfection, not taking antibiotics as prescribed, antibiotic resistance, or immunodeficiency.

• Reinfection

You can get reinfected with strep bacteria after making a full recovery. This means that you recovered from the infection, but were exposed and infected by new strep bacteria. This is a common cause of recurrent strep in adults who take their full course of antibiotics as prescribed.

• Not taking antibiotics as prescribed

Many people start to feel much better within a few days of starting antibiotics. Some physicians even suggest sending children back to school just 12 hours after their initial dose. However, even if your symptoms go away, strep bacteria may still linger, posing the risk of recurrent infection if you don’t finish the full course of antibiotics.⁴

• Antibiotic resistance

As discussed in the previous section, people who are allergic to penicillin are more prone to recurring strep throat. Individuals who can’t take amoxicillin or penicillin, the go-to antibiotics used to treat strep that are less likely to result in antibiotic resistance, can be prescribed other antibiotics, like clindamycin, erythromycin, and azithromycin. But, antibiotic resistance with these medications is more likely.⁵

With antibiotic resistance, the bacteria don’t respond to the antibiotics. As a result, your infection won’t fully clear.

• Immunodeficiency

Immunodeficiency is an underlying problem with the immune system that inhibits it from effectively fighting off pathogens. Examples include HIV, AIDS, and CVID (common variable immunodeficiency).⁶ 

Treating Recurring Strep Throat

Let’s discuss how to stop recurring strep throat with trusted treatment options, including re-treatment with the same antibiotic, switching antibiotics, and sore throat remedies.

If you take amoxicillin for strep throat and your infection returns, your physician will likely recommend another complete course of amoxicillin. This is often effective if you stopped your first course early or were re-exposed to the virus.

For people who have to take amoxicillin alternatives for strep throat due to an allergy, trying a different antibiotic may help treat chronic strep throat. This can help if your body is resistant to the first antibiotic. Additionally, people respond to various antibiotics differently, so it can take some trial and error to find the best medication for recurrent strep throat.

Alternative treatments for sore throat pain relief

Home remedies can help alleviate your pain while you’re taking antibiotics for the strep infection. Always read drug facts label and reach out to your healthcare provider should you have any questions with symptom managment options while on your antibiotics. These options include:Mucinex InstaSoothe™ Sore Throat + Pain Relief Spray helps fight severe sore throat pain with a soothing, easy-to-use spray. 

• Over-the-counter medications can provide temporary relief from symptoms like sore throat, fever, and headache. Examples include:

• Mucinex InstaSoothe™ Sore Throat + Soothing Comfort and InstaSoothe™ Sore Throat + Pain Relief Drops help relieve sore throat pain with a fast-acting 3-in-1 formula.

• Mucinex InstaSoothe™ Sore Throat + Pain Relief Spray helps fight severe sore throat pain with a soothing, easy-to-use spray.

Medications that help combat congestion or coughing, like Mucinex Maximum Strength Mucinex® DM Extended-Release Bi-Layer Tablets, are a better fit for cold and flu symptoms.

• Drinking warm beverages, like tea with honey, warm water with lemon, or broth can help soothe a painful sore throat.
• Sticking to soft, soothing foods, like smoothies, frozen yogurt, soup, applesauce, yogurt, and soft eggs, is a sore throat relief option that can help keep your throat as comfortable as possible. Steer clear of acidic and spicy foods that could irritate your throat.⁷
• Take salt water gargles with ¼ to ½ of a teaspoon of table salt in eight ounces of warm water.

How Do I Treat and Prevent Recurrent Strep Throat?

To treat and prevent recurrent strep throat, you can take antibiotics exactly as advised, practice good hygiene, refrain from sharing personal items, change your toothbrush, and support your immunity with healthy lifestyle habits.

• Take antibiotics as advised

To treat and prevent recurrent strep throat, it’s important to take your entire course of antibiotics, exactly as prescribed. Stopping early or not taking the entire dose can cause recurring strep throat by not fully eradicating the bacteria.

• Practice good hygiene

Especially if you’re often in crowded spaces or around school-age children, good hygiene is crucial to strep throat prevention. Wash your hands frequently with warm water and soap for at least 20 seconds, especially after touching communal surfaces or shared items. Don’t touch your eyes, nose, or mouth, as bacteria will transfer from your fingers to your body.

• Don’t share personal items

Sharing items like glasses, water bottles, straws, and utensils can facilitate the spread of strep bacteria. To keep all of the members of your household safe and healthy, wash these items in the dishwasher or thoroughly by hand with hot, soapy water.

• Change your toothbrush

Strep bacteria can stay behind on your toothbrush bristles and reinfect you. So, make sure to replace your toothbrush a few days after you’ve started a course of antibiotics, and every two to three months thereafter.⁸

• Maintain a healthy lifestyle

While you can’t always control being exposed to strep bacteria, you can strengthen your immune system to ensure it effectively wards off pathogens. Drink plenty of water each day, eat a nutritious diet, maintain a consistent sleep schedule, and practice stress management strategies to promote optimal immune function.

When to Seek Additional Medical Help

Strep throat requires professional medical care with antibiotics for a full recovery. So, contact your doctor for professional care if you or your child experiences any of the following:

• A fever
• Sore throat that lasts more than two days
• Sore throat with swollen, tender lymph nodes
• Difficulty swallowing or breathing

If you’ve been diagnosed with strep throat, call your doctor if you don’t experience symptom improvement within 48 hours of taking your first dose of antibiotics.⁹

Recurrent strep throat can be painful and discouraging. But, relief is possible with professional care from a trusted physician.

References

1. Strep Throat. John Hopkins Medicine. Published March 22, 2023. https://www.hopkinsmedicine.org/health/conditions-and-diseases/strep-throat
2. Strep Throat: Symptoms, Causes, Diagnosis & Treatment. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/4602-strep-throat#signs-and-symptoms
3. About Strep Throat. CDC. Published March 1, 2024. https://www.cdc.gov/group-a-strep/about/strep-throat.html
4. Recurrent Strep Throat: What To Do When Strep Comes Back. Cleveland Clinic. Published April 29, 2024. https://health.clevelandclinic.org/recurring-strep-throat
5. Clinical Guidance for Group A Streptococcal Pharyngitis. CDC. Published April 23, 2024. https://www.cdc.gov/group-a-strep/hcp/clinical-guidance/strep-throat.html
6. Common Variable Immunodeficiency (CVID) | NIH: National Institute of Allergy and Infectious Diseases. National Institute of Allergy and Infectious Disease. Published April 23, 2019. https://www.niaid.nih.gov/diseases-conditions/common-variable-immunodeficiency-cvid
7. Strep throat - Diagnosis and treatment - Mayo Clinic. Mayo Clinic. Published 2018. https://www.mayoclinic.org/diseases-conditions/strep-throat/diagnosis-treatment/drc-20350344
8. Should You Throw Away Your Toothbrush After Being Sick? Cleveland Clinic. Published March 13, 2020. https://health.clevelandclinic.org/throw-away-toothbrush-sick
9. Mayo Clinic. Strep throat. Mayo Clinic. Published November 30, 2022. https://www.mayoclinic.org/diseases-conditions/strep-throat/symptoms-causes/syc-20350338